MEDICARE: WEST TEXAS HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1518139237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST TEXAS HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 130010
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75713-0010
Country	:	US
Telephone Number	:	903-581-1223
Fax Number	:	903-581-1253

Provider Business Practice Location Address
First Line	:	3134 EXECUTIVE DR STE B
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76904-6886
Country	:	US
Telephone Number	:	325-655-6600
Fax Number	:	325-655-6602

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL ROBERT WILLSON
Credential	:
Telephone Number	:	903-581-1223

Provider Enumeration Date	:	04/02/2008
Last Update Date	:	04/30/2026

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